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San Diego, CA
Blepharoplasty - Lower Lids - Transcutaneous, Transconjunctival with laser resurfacing - or - fillers?
I am a 56 year old woman who had a blepharoplasty on both my upper and lower lids back in 1996. I am considering getting both my upper and lower lids done again. I have consulted several surgeons and they all have different opinions about my lower lids - one surgeon does not recommend surgery but a filler in my tear trough area; one surgeon recommended a transcutaneous blepharoplasty on my lower lids with skin removal; and another surgeon recommended transconjunctival blepharoplasty with laser resurfacing on my lower lids. I am not sure which route to take. Any feedback would be helpful. I have attached 3 photos to this posting.
Over the internet very hard to advise. My possible plan is a revision of uppers with skin excess removal. Open skin flap lower lid with lateral fat removal, fat to tear trough and canthopexy. Best to you.
The main question is what in the upper and in the lower lids that bothers you?
What changes you want to see?
Why you want an upper and lowe lid blepheroplasty?
Oce you communicate your input to your plastic surgeon then we can formulate a plan.
What I see in your eyes may not bother you.
for example the upper lids, is what you want an excision of skin or may be a brow lift?
Lower lid has lots of herniated orbital fat, and a significan tear trough.
I would remove some of the fat(very little) and redistribution of the rest of the fat to soften the tear trough.
The lateral fat compartment is prominent, but there is a depression lateral to that at the lateral canthus?
The skin is good, very little fine wrinkles. Laser resurfacing is redundant.
Compare the eyes now to a picture of you in your thirties.
Thank you for the helpful pictures. I think you need a trans-conjunctival removal of recurrent fat and some repositioning into the naso-jugal depression. No skin removal ! and be very careful about laser resurfacing because it too can cause lid rounding if not done extremely careful.
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